小児急性骨髄性白血病に対する多剤併用プロトコール(MINI-COAP)療法

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A total of 25 children with previously untreated acute myelogenous leukemia (peroxidase positive) in sequence between 1972 and 1977 were treated with a five-drug protocol (MINI-COAP regimen) using vincristine (VCR), prednisolone (Pred), cytosine arabinoside (Ara-C), cyclophosphamide (CPM) and 6-mercaptopurine (6 MP).The rate of complete remission was 76%. Of 17 children who achieved complete remissions including one partial remission, eight, 1972∼1974, were maintained with daily 6MP plus periodic reinforcement by MINI-COAP induction every 4 weeks, and nine patients, 1975∼1977, were randomized to maintenance regimen A and regimen B. The maintence chemotherapy program of both A and B was the same as that for the patients of 1972∼1974 including reinforcement of MINI-COAP induction every 3 weeks instead of 4 weeks. The patients in Regimen A received additional immunotherapy with BCG-CWS.The overall median duration of the initial complete remissions was 6 months, but three patients (one in Regimen A, two in Regimen B) are still remaining in initial complete remission for 13∼22 months. There is no difference in the duration of complete remission or survival between regimen A and B.Although the results do not compare well to those of the lymphoblastic leukemia, long-term disease free survival can be achieved with a multiple-drug intensive treatment in acute mylogenous leukemia in childhood.
一般社団法人日本血液学会の論文